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PubMed2004

Gap junction communication dynamics and bystander effects from ultrasoft X-rays.

Gap junctions provide a route for small molecules to pass directly between cells. Toxic species may spread through junctions into 'bystander' cells, which may be exploited in chemotherapy and radiotherapy. However, this may be prevented by junction closure, and therefore an understanding of the dose-dependency of inhibition of communication and bystander effects is important. Low-energy ionising radiation (ultrasoft X-rays) provides a tool for the study of bystander effects because the area of exposure may be carefully controlled, and thus target cells may be clearly defined. Loss of gap junction-mediated intercellular communication between irradiated cells was dose-dependent, indicating that closure of junctions is proportional to dose. Closure was associated with hyperphosphorylation of connexin43. Inhibition of communication occurred in bystander cells but was not proportional to dose. Inhibition of communication at higher radiation doses may restrict the spread of inhibitory factors, thus protecting bystander cells. The reduction in communication that takes place in bystander cells was dependent on cells being in physical contact, and not on the release of signalling factors into the medium.

Animals↗
PubMed2004

Patient communication during cataract surgery.

PURPOSE: Most cataract surgery is now performed under local anaesthesia on a day-case basis. As patients are fully conscious during the procedure, it is important that they remain still. There are a variety of reasons why patients may need to move, and it is important that the surgeon is made aware that this may happen. Some centres offer a nurse's hand as a means of perioperative patient communication. We sought to study the safety and efficacy of using an electronic patient-controlled alert device. METHOD: We compared hand-holding with the use of a patient alert device, and with both communication methods at the same time, on 150 subjects undergoing cataract surgery under local anaesthesia. Assessment of pre- and postoperative state anxiety was undertaken and patients' satisfaction with the communication strategies was assessed. RESULTS: There was a significant difference between pre- and postoperative state anxiety for each group (P<0.001) but no significant differences in pre-, peri-, or postoperative state anxiety between groups. There were no significant differences in confidence, pain, understanding, satisfaction, memory, and reassurance between the three groups. A total of 46% of all patients reported experiencing one or more of the potential problems enquired about, during the operation. Significant correlations were also identified between some of the psychological variables investigated. CONCLUSIONS: An electronic patient alert device is as effective a means of perioperative patient communication as holding a nurse's hand, during cataract surgery under local anaesthesia. It is safe, reassuring and it allows patients to communicate directly with the surgeon.

Aged↗
PubMed2004

Health risk communication using comparative risk analyses.

The ability to communicate effectively the degree or magnitude of public exposures or health risks is essential for risk assessors and risk managers. Various guidelines exist for communicating environmental and public health risks, including recommended approaches for putting risk data into proper context. Although it remains unclear as to which approach is the most useful or appropriate under different circumstances, risk comparisons are a popular choice for conveying the significance of or providing a better perspective on a particular chemical exposure or health risk. In this paper, several different types of risk comparisons are described that are frequently used in the private and public sectors, and these are illustrated using a variety of examples from the literature. These approaches include: (1) intrachemical comparisons, (2) interchemical comparisons, (3) comparisons to background levels of risk, (4) comparisons to theoretical risks or safety levels, and (5) comparisons to other actions or activities. The primary purpose of this paper is to summarize and briefly discuss the advantages and limitations of these risk communication approaches. The evolving field of risk communication is also discussed, including ongoing research on public risk perceptions and alternative methods for communicating risk magnitudes and data uncertainties.

Communication↗
PubMed2005

E-mail and oncology: a survey of radiation oncology patients and their attitudes to a new generation of health communication.

Electronic mail (e-mail) is a powerful tool that can greatly enhance communication and has numerous potential applications within the medical profession. Physician-patient e-mail communication volume is increasing, but little research has addressed patient interests and concerns about this now commonplace technology. The goals of this study were to review the available literature regarding physician-patient e-mail practices, evaluate patient interest, assess patient perspectives about how e-mail communication might facilitate medical treatment and advice, and determine areas of patient concern regarding e-mail communication with their physicians. To this end, a population of cancer patients was sent a written survey designed to assess their access to e-mail and attitudes about physician-patient e-mail communication. We found that patients favored e-mail for increased convenience, efficiency, and timeliness about general health problems, while it was not favored for urgent matters.

Aged↗
PubMed2005

Do you remember? How caregivers question their spouses who have Alzheimer's disease and the impact on communication.

This study examined the types of questions caregivers use and their outcomes when conversing with their spouse with Alzheimer's disease (AD). Of particular interest was caregivers' use of yes-no and open-ended questions and the demands they make on the memory of the person with AD. It was hypothesized that communication between caregivers and their spouses would be more successful when caregivers used yes-no rather than open-ended questions; however, it was also predicted that a more positive communication outcome would occur when caregivers used open-ended questions that requested information from semantic rather than episodic memory. Eighteen caregivers and their spouses diagnosed with AD were audiotaped while they conversed for approximately 10 min on a topic of their choosing. The conversations were transcribed and coded according to the occurrence of questions, the type of question (yes-no, choice, or open-ended), the type of memory required to respond to a question (semantic or episodic), and the outcome of a response to a question (communication breakdown). The results indicated that caregivers used yes-no and open-ended questions to a similar extent, whereas episodic questions were used almost twice as frequently as semantic questions. Communication was more successful when caregivers used yes-no compared with open-ended questions and when questions placed demands on semantic rather than episodic memory. The findings from this study suggest that caregivers can reduce communication problems by avoiding the use of questions that depend on episodic memory. In addition, while yes-no questions were associated with more favorable outcomes than open-ended questions, the latter do not need to be avoided if they refer to information that draws only on semantic memory.

Aged↗
PubMed2006

Reliability issues and solutions for coding social communication performance in classroom settings.

PURPOSE: To explore the utility of time-interval analysis for documenting the reliability of coding social communication performance of children in classroom settings. Of particular interest was finding a method for determining whether independent observers could reliably judge both occurrence and duration of ongoing behavioral dimensions for describing social communication performance. METHOD: Four coders participated in this study. They observed and independently coded 6 social communication behavioral dimensions using handheld computers. The dimensions were mutually exclusive and accounted for all verbal and nonverbal productions during a specified time frame. The technology allowed for coding frequency and duration for each entered code. Data were collected from 20 different 2-min video segments of children in kindergarten through 3rd-grade classrooms. Data were analyzed for interobserver and intraobserver agreements using time-interval sorting and Cohen's kappa. Further, interval size and total observation length were manipulated to determine their influence on reliability. RESULTS: The data revealed interval sorting and kappa to be a suitable method for examining reliability of occurrence and duration of ongoing social communication behavioral dimensions. Nearly all comparisons yielded medium to large kappa values; interval size and length of observation minimally affected results. Implications The analysis procedure described in this research solves a challenge in reliability: comparing coding by independent observers of both occurrence and duration of behaviors. Results indicate the utility of a new coding taxonomy and technology for application in online observations of social communication in a classroom setting.

Adult↗
PubMed1975

The communication game: dump and play.

Communication entails much more than formulating a linguistic code to map underlying intents. It entails the utilization of a role-taking attitude in reconciling communicative obstacles that arise from significant speaker-listener discrepancies in form or code, reference or representation, and license or acceptability. Young children communicate in a "talk to" fashion that essentially is issuing or dumping messages. As role-taking attitudes become acquired, communicative efforts change from merely dumping messages to active resolution of communicative obstacles in an effort to achieve the message of best fit for a particular situation.

Child↗
PubMed1977

Blissymbolics-a nonverbal communication system.

Until recently, speech-language pathologists have shown little interest in seeking alternate forms of communication when functional verbal communication is not attainable. There is a paucity of literature dealing with nonverbal communication systems for people lacking functional verbal communication for reasons other than deafness. Blissymbolics is a logical, visual language that has provided functional communication for nonverbal cerebral-palsied children. The full potential and application of Blissymbolics has only begun to be realized, and there is much need for experimentation and research. This paper describes the system and suggests areas for future application and development.

Cerebral Palsy↗
PubMed1983

Evaluating the effectiveness of a communication board training program.

This study introduces a technique for systemically observing the consequences of various aspects of treatment on the communicative effectiveness of nonspeaking persons using communication boards in natural settings. The case study of Kay, a 24-year-old nonspeaking woman residing in a nursing home, is presented. Three major factors were found to operate cumulatively in increasing Kay's overall communicative effectiveness: 1) revising the design of her original communication board; 2) training her to functionally use her new board to meet her daily communicative needs; and then 3) introducing interaction strategies to her listeners through an inservice training program. Highlights of Kay's and her staff's programs are discussed.

Adult↗
PubMed1990

The incidence of communication disorders in dysphagic patients.

A retrospective study investigated the incidence and types of communication problems in 115 patients referred for swallowing difficulties. Each patient had a bedside swallowing evaluation completed as well as a screening of communication abilities. A formal speech-language evaluation was done when warranted and possible. Of the 115 patients, 93 had suspected swallowing problems based on the bedside evaluation done by the speech-language pathologist. Videofluoroscopy was performed on 85 of these patients. A significant positive correlation was found between communication impairments and both suspected and videofluoroscopically confirmed dysphagia. Cognitive problems were the most frequent communication impairment with dysarthria being second. Neurological diseases were the most common medical diagnoses in patients with swallowing difficulties. The case is presented for the speech-language pathologist to be the primary diagnostician and manager of both communication and oral-pharyngeal swallowing disorders whether they co-occur or not.

Adult↗
PubMed1990

Partner sensitivity to communication behavior of young children with developmental disabilities.

Aspects of partner sensitivity to communication behaviors of 24 presymbolic children with developmental disabilities were examined. The children were grouped according to their movement abilities (normal vs. abnormal patterns) and communication status (intentional vs. preintentional). Participating communication partners were those with whom the children interacted on a regular basis and included their mothers, early childhood special educators, and speech-language pathologists. Procedures were developed whereby the partners served as informants in order to provide information regarding (a) recognition of the children's communicative cues and (b) consistency of cue recognition and descriptions across partners. Results indicated wide individual variability in the partners' basic recognition abilities as well as their consistency with each other. Further, the observed variations could not be attributed to the children's movement and communication abilities. It was concluded that sensitivity, as measured in the present investigation, was highly partner-child specific, with some children likely to be exposed to more optimal interactions than others.

Child, Preschool↗
PubMed1991

The effects of information and augmentative communication technique on attitudes toward nonspeaking individuals.

This study investigated the effects of printed factual information and three augmentative communication techniques on attitudes of nondisabled individuals toward nonspeaking persons with physical disabilities. Employing a 3 (augmentative communication techniques) x 2 (presence/absence of information) factorial design, subjects viewed a videotape depicting a nonspeaking adult having a conversation with a normal-speaking individual. Subjects in Condition 1 viewed a tape depicting the nonspeaking individual using unaided communication techniques; Condition 2 subjects viewed the individual using an alphabet board; subjects in Condition 3 viewed the individual using a computer-based voice output communication aid (VOCA). A scale assessing attitudes toward nonspeaking persons, the Attitudes Toward Nonspeaking Persons Scale (ATNP), was developed and validated for purposes of this study and was employed as the dependent measure. Results revealed that subjects expressed more favorable attitudes when provided with the additional information concerning the nonspeaking individual. Attitude favorability also increased with the sophistication of the augmentative communication technique.

Adult↗
PubMed1992

The relationship between communication attitude, anxiety, and depression in stutterers and nonstutterers.

People who stutter are frequently viewed as more anxious than nonstutterers and as being depressed. Further, a strong and pervasive stereotype is held by nonstutterers that people who stutter are guarded, nervous, and tense. This study examined self-perceptions of general state and trait anxiety, depression, and communication attitude in matched groups of stutterers and nonstutterers. Results refute the assertion that people who stutter are more anxious or depressed than those who do not. Anxiety and depression are not related to self-ratings of stuttering severity. Communication attitude is negative for this group of people who stutter and becomes increasingly negative as self-ratings of stuttering become more severe. People who stutter, grouped by severity rating, differed in the strength of the relation between measures of communication attitude, anxiety, and depression. Findings suggest that the anxiety of people who stutter is restricted to their attitude towards communication situations and that it is a rational response to negative communication experiences.

Adolescent↗
PubMed1992

Communicative gestures in children with delayed onset of oral expressive vocabulary.

Use of communicative gestures in a group of children with delayed onset of expressive oral vocabulary (late talkers) was compared with such use among normal-language-matched controls and age-matched controls. Analyses revealed that late talkers used significantly more communicative gestures and for a greater variety of communicative functions than did language-matched controls. However, a 1-year follow-up revealed that 4 of the late talkers remained delayed (truly delayed late talkers) and 6 caught up (late bloomers). Reanalyses of Year 1 data based on these follow-up outcomes demonstrated that only late bloomers used more communicative gestures than did language-matched controls. Truly delayed late talkers did not differ from language-matched controls either for number of gestures, type of gestures (symbolic vs. nonsymbolic), or number of different functions for which gestures were used. Late bloomers also used more communicative gestures than did age-matched controls, suggesting that they (the late bloomers) were using gestures to compensate for their small oral expressive vocabulary. Results are discussed in the context of early predictors of risk for language impairment and relationships between language and cognition.

Child Language↗
PubMed1998

Communication between deaf children and their hearing mothers: the role of language, gesture, and vocalizations.

In the present longitudinal study, 20 deaf and 20 hearing children were observed during free play with their hearing mothers when the children were 22 months and 3 years of age. Compared to hearing children, deaf children were severely language delayed, with deaf 3-year-olds using less language (speech or sign) than hearing 22-month-olds. Deaf children communicated primarily through nonlinguistic vocalizations, with increasing use of gesture from 22 months to 3 years of age. Although mothers of deaf children used more visual communication than mothers of hearing children, they still primarily communicated through speech. In addition, deaf children did not visually attend to much of their mothers' communication. Therefore, deaf children received much less communication than hearing children. These results suggest that intervention efforts should be focused on increasing the quantity of perceived linguistic input by the child.

Age Factors↗
PubMed1999

Older adult performance on the Communication Profile for the Hearing Impaired: gender difference.

Gender difference in auditory function with age is well documented. However, little is known about the influence of interacting sensory, psycho-social, and economic variables on adjustment to hearing loss. Adjustment to acquired, mild-to-moderate hearing loss by advantaged older women and men was examined using the Communication Profile for the Hearing Impaired (CPHI) (Demorest & Erdman, 1987). Correlational analyses revealed relationships between scales to be similar for women and men. Controlling for socio-demographic and hearing variables, group responses for the majority of CPHI scales did not differ significantly. Six scales differed significantly, and those results are discussed. When compared to men, women assigned greater importance to effective social communication, were more likely to use nonverbal communication strategies, reported greater anger and stress, and reported greater problem awareness and less denial associated with hearing loss. The CPHI is a useful tool for specifying parameters of perceived communication handicap for both older men and women. Findings underscore the need to consider gender-specific self-assessment of communication and personal adjustment in clinical management of older adults with age-related hearing loss.

Adult↗
PubMed2000

Age differences in the use of informative/heuristic communicative functions in young children with and without hearing loss who are learning spoken language.

Previous research has suggested that the normal development of communicative functions proceeds from the directing or "instrumental" types to the informative or "heuristic" types with age. This paper describes a cross-sectional study of communicative function in children with profound hearing loss and children with normal hearing, from ages 12-54 months. The children with hearing loss were learning spoken English as their primary means of communication. The primary purpose of the study was to evaluate whether the pattern of age differences seen in the two groups of children (those with and without normal hearing) are similar patterns that occur at differing chronological ages, or whether they are dissimilar patterns altogether. A second purpose was to examine the relationship between the use of informative/heuristic functions and the acquisition of vocabulary and syntax. The data suggested a somewhat different pattern of communicative function development in children with and without hearing loss. In addition, the use of language for social purposes was closely related to the achievement of traditional language milestones. In both normally hearing children and in those with hearing loss, the correlations between the use of informative-heuristic functions and various measures of language development indicated that the more mature uses of language co-occur with increased frequency of communication, larger vocabulary, and longer utterance length. These results document that when linguistic improvements such as increasing vocabulary size and sentence length occur in deaf children learning spoken English, they are used for appropriate and informative social purposes that are commensurate with their language age.

Age Factors↗
PubMed1998

Outcome of recommendations for augmentative communication in children.

Some children with severe motor disorders have unintelligible speech, and may be recommended augmentative communication systems, such as a symbol chart or a voice output aid. The paper reports the outcome after 15-18 months for 35 children of recommendations for augmentative communication. Using structured questionnaires, parents were asked whether equipment was provided as recommended. Their perception of success in children's use of augmentative aids was recorded and related to potentially influential factors. Twenty-five symbol systems, 10 speech output devices and 11 switches were received; 18 symbol systems were used for communication and 10 were used frequently. Seven speech output devices were used for communication but only two were reported to be used frequently. Factors leading to more successful outcomes include early receipt of the aid, perceived adequate local training in the use of the aid, and children aged 6 years or more at initial assessment. The findings also suggest that referring professionals will need to be better informed about the nature and limitations of augmentative communication aids, and that improved local professional input and careful interagency planning and co-ordination are required to achieve optimal outcome.

Adolescent↗